Unknown Individual – Pediatrics Physician, NPI 1861525164

Unknown Individual is a healthcare provider. based in Price, Utah. specializing in Pediatrics Physician. They hold a License No. 57443801205 (UT). The NPI Number for Unknown Individual is 1861525164

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861525164
Phone
(435) 637-7100
Address
70 W MAIN ST
Deactivation Date
1 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7032390300
Graduation Year
1980 (46 years ago)
PAC ID
5991755746
Group Practice PAC ID
2264586106
Professional Enrollment ID
I20150512000067
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 70 W MAIN ST

    PO BOX 1015

    PRICE, UT 845012804

    Phone: (435) 637-7100

    Fax: (435) 637-7101

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84501)

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Provider's Procedures

Unknown Individual performs procedures in Pediatrics Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL PRACTICEUT81002Urinalysis, manual test3934

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2264586106View full group profile

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1861525164 when you need to reference Unknown Individual in forms, claims, or directories.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Price, Utah for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1861525164. Always confirm identity and privileges with the practice and licensing boards.

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